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Korean J Spine 2005;2(4): 333-341.
13
A Small Amount of Bone Cement Injected Vertebroplasty Utilizing Percutaneous Vertebral Body Access(PVBA) Technique for Osteoporotic Vertebral Fractures
Kyung-Suk Lee, M.D., Yong-Jun Cho, M.D., Jong-Hun Choi, M.D., Sung-Min Cho, M.D.,Kyung-Sik Ryu, M.D., Myung-Soo Ahn, M.D.
epartment of Neurosurgery, Chunchon Sacred Heart Hospital, College of Medicine, Hallym University, Chunchon, Korea
A Small Amount of Bone Cement Injected Vertebroplasty Utilizing Percutaneous Vertebral Body Access(PVBA) Technique for Osteoporotic Vertebral Fractures
Kyung-Suk Lee, M.D., Yong-Jun Cho, M.D., Jong-Hun Choi, M.D., Sung-Min Cho, M.D.,Kyung-Sik Ryu, M.D., Myung-Soo Ahn, M.D.
Abstract
Objective: Although large amounts of bone cement can easily increase the strength of fractured vertebrae, it can cause serious leakage of bone cement. Use of a small amount of bone cement appears to improve the safety of the procedure. Percutaneous vertebral body access(PVBA) technique through the posterolateral extrapedicular approach was recently developed to overcome the problems related to a large amount of bone cement. Our purpose is to evaluate the efficacy of this procedure and analyse the surgical outcomes.
Methods: A retrospective review was performed in 92 levels of 82 patients who underwent percutaneous vertebroplasty utilizing posterolateral PVBA technique between May 2003 and March 2005. The average amount of the implanted bone cement was 1.5節ž2.5mL in thoracic levels and 2.5節ž4.0mL in lumbar levels. The clinical outcome was assessed using a visual analogue scale(VAS).
Results: The treated vertebrae varied from T5 to L5, but T12 and L1 occupied 56.5%. The compression rate was statistically improved from 25.75%짹14.96 to 23.79%짹15.32(p<0.05), but the kyphotic angle was improved from 8.7째짹5.6 to 8.0째짹5.4 (p>0.05). Preprocedural VAS was 8.26짹1.14 decreasing to 1.54짹1.20(p<0.01). Postprocedural bone cement leakage was noted in 18 levels(19.6%). There was no case of leakage to epidural space or segmental artery injury, and no newly developed fracture.
Conclusion: The results of this study suggest that use of a small amount of bone cement utilizing PBVA technique may improve clinical symptoms without specific complications.
Keywords: Vertebroplasty.Osteoporosis.Spinal fractures.Bone cements
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